title: The effect of monitored chlorhexidine gel treatment on mutans streptococci in margins of restorations.
abstract: OBJECTIVE
  The objective of this study was to compare the effect of a monitored chlorhexidine (CHX) gel treatment with a conventional two-day CHX treatment in subjects with well-restored dentitions and high numbers of salivary mutans streptococci (MS).
  
  
  METHODS
  In the test group (n = 8), the effect of the CHX gel applications was monitored in margins of restorations and in saliva during a period of 12 weeks. Strip Mutans was used for monitoring and whenever a sample revealed growth of MS, the subject received a 3 x 5 min 1% CHX gel treatment at the clinic. Nine subjects (control group) were only given the baseline (conventional) treatment with CHX gel 3 x 5 min on two consecutive days.
  
  
  RESULTS
  The monitored treatment in the test group resulted in a more pronounced reduction of MS both in margins of restorations and in saliva than the conventional treatment. The difference between the level of MS in the margins in the two groups was, however, only significant at the 20-week examination. There was a large individual variation in the effect of the CHX treatment, and three to nine extra CHX gel applications were needed in the test group to keep MS below a detectable level during the 12 weeks.
  
  
  CONCLUSIONS
  Our findings illustrate the difficulties to obtain a long-lasting reduction of MS in subjects with a large number of restorations and a high number of MS by antimicrobial treatment only. The results indicate the necessity to combine antimicrobial treatment with, for example, sucrose restriction, in order to keep MS at a low level for a longer period of time.
authors.affiliation: Department of Cariology, Faculty of Odontology, Göteborg University, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Wallman
authors.forename: B
authors.initials: B
authors.lastname: Krasse
authors.forename: D
authors.initials: D
authors.lastname: Birkhed
authors.forename: S
authors.initials: S
authors.lastname: Diacono
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003442:Crowns; D004245:DMF Index; D003723:Dental Amalgam; D003773:Dental Plaque / Q000382:microbiology; D003793:Dental Restoration, Permanent; D019422:Dietary Sucrose / Q000008:administration & dosage; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D011934:Reagent Strips; D012463:Saliva / Q000382:microbiology; D013295:Streptococcus mutans / Q000187:drug effects* / Q000254:growth & development; D014070:Tooth / Q000382:microbiology*
chemical_list: D000891:Anti-Infective Agents, Local; D019422:Dietary Sucrose; D005782:Gels; D011934:Reagent Strips; D003723:Dental Amalgam; C010882:chlorhexidine gluconate; D002710:Chlorhexidine